Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·Pathology, Occupational Medicine, Pain Management +1 more·Coding
Effective date
Oct 1, 2026
We identified it
Aug 26, 2026
Summary
Effective October 1, 2026, Ambetter Health will no longer reimburse CPT codes 80320-80377 (Definitive Drug Testing Procedures). Providers must transition to billing G-series bundled laboratory codes instead to maintain reimbursement for these services.
Action Required
By September 30, 2026: Billing team must update billing software to stop accepting CPT codes 80320-80377 for Ambetter Health claims. Identify the appropriate G-series bundled laboratory codes that correspond to each CPT code 80320-80377 procedure currently billed and map them in the system. Audit all standing orders, templates, and encounter forms used by providers to remove or replace references to CPT codes 80320-80377. Train providers and billing staff on the new G-series code requirements. Contact Ambetter Health Provider Relations Representative to obtain specific G-code mappings if not already available. Failure to transition will result in claim denials and loss of reimbursement for definitive drug testing procedures.